Vitamin A and body weight status do not impact humoral immunity against measles, mumps or rubella in individuals 4 to 18years old: a cross-sectional cohort study in India.

Investigating the efficacy of propranolol in treating chronic stress combined with colorectal cancer in mice and its antitumor potential.

To investigate associations between prepregnancy cardiometabolic risk factors and early childhood weight status, independent of genetic susceptibility. The ancillary study of the HCHS/SOL (Hispanic Community Health Study/Study of Latinos) included 227 dyads consisting of Hispanic/Latina mothers who had singleton live births between baseline and visit 2 and their children, aged 3-9 years. Child outcomes included body mass index (BMI) z-scores, and weight status categories. Maternal prepregnancy biomarkers included fasting triglycerides, high-density lipoprotein cholesterol (HDL-C), glucose, insulin, blood pressure, BMI, and waist circumference. Child DNA was used to calculate a polygenic risk score for obesity. Linear and logistic regression models adjusted for confounders and child genetic risk. On average, 10.9 years elapsed between maternal baseline assessment and child anthropometry. At baseline, 4.8% of women reported having diabetes or hypertension, one-third had obesity (BMI 30 or higher), and more than half had elevated waist circumference or low HDL-C. Among children (mean age 7.5 years), 17.2% were categorized as having overweight and 27.8% were categorized as having obesity. Higher maternal BMI, larger waist circumference, and higher fasting insulin and diastolic blood pressure were significantly associated with higher child BMI z-scores. A 1-SD increase in maternal BMI (6.1 units) or waist circumference (13.3 cm) was linked to greater odds of child overweight or obesity. Elevated maternal insulin was associated with having a child with overweight status, and higher diastolic blood pressure with having a child in the obesity category in minimally adjusted models. Prepregnancy cardiometabolic risk factors in Hispanic/Latina women are associated with higher BMI and obesity risk in their children, independent of genetic predisposition. These findings highlight the prepregnancy period as a critical window for interventions to improve intergenerational health outcomes.

The effect of childhood body weight status on cardiovascular disease risk in adulthood: A narrative review.

Recurrent weight gain after bariatric surgery (BS) or endoscopic bariatric therapy (EBT) remains a long-term clinical challenge, potentially undermining long-term treatment success. Tirzepatide, a dual agonist of the glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptors, has shown promising results in obesity treatment, but data regarding its use in post BS or EBT recurrent weight gain are limited. This observational cohort study evaluated the effectiveness and safety of tirzepatide in patients with recurrent weight gain after BS or EBT. Anthropometric data, BMI categories, and adverse events were collected at baseline and after 24 weeks of treatment. A total of 34 patients (26 females, 8 males) who experienced recurrent weight gain after BS (n = 32) or EBT (n = 2) were treated with once-weekly subcutaneous tirzepatide (dosing range 2.5-10mg/week). After 24 weeks, the mean percentage total body weight loss (%TBWL) was 18.1 ± 5.6% (p < 0.0001), with a significant reduction in waist circumference (p < 0.0001). Most patients shifted to lower BMI categories, with the majority reaching overweight or normal weight status. Adverse events were exclusively gastrointestinal (constipation, diarrhea, nausea), generally mild, and did not lead to treatment discontinuation. Preliminary evidence suggests that tirzepatide is associated with significant weight loss and good tolerability in this observational cohort for managing recurrent weight gain after bariatric surgery and endoscopic bariatric therapy. These findings suggest a potential role for tirzepatide as a valuable nonsurgical option in the multidisciplinary management of patients experiencing recurrent weight gain after bariatric procedures.

Weight-related self-stigma and internalised weight bias may intensify food cravings and undermine psychological resources such as self-esteem, yet their combined contribution to food cravings among women with overweight and obesity is not well characterized. This study compared these psychosocial factors between women with overweight and those with obesity and examined their independent associations with food craving. The sample included 179 women with BMI ≥ 25 who completed a sociodemographic questionnaire and validated measures of weight-related self-stigma, internalised weight bias, food craving, and self-esteem. Group differences were examined, and hierarchical multiple regression was used to identify psychosocial predictors of food craving. Compared with women with overweight, women with obesity reported higher levels of weight-related self-stigma (p = 0.001), internalised weight bias (p = 0.001), and food craving (p = 0.003). Self-esteem did not differ by weight status but was significantly negatively associated with weight-related self-stigma, internalised weight bias, and food craving. Hierarchical regression analysis showed that greater weight-related self-stigma (β = 0.260) and internalised weight bias (β = 0.222), along with lower self-esteem (β = 0.184), independently predicted higher food craving, explaining 38.9% of the variance (R²=0.389). Age remained a significant negative predictor of food craving. Importantly, aside from age, BMI category and other sociodemographic variables were included as covariates in the hierarchical model but did not emerge as significant predictors. Food craving in women with overweight and obesity appears to be significantly associated with modifiable psychosocial mechanisms, particularly weight-related self-stigma, internalised weight bias, and self-esteem. Integrating stigma-reduction and self-esteem-supportive components into obesity management may help improve psychological and behavioral outcomes beyond standard dietary advice.

To examine the association between body mass index (BMI), Body Roundness Index (BRI), and A Body Shape Index (ABSI), with handgrip strength (HGS) and dynapenia in postmenopausal women. This is a cross-sectional study involving 259 postmenopausal women. Age, age at menopause, alcohol consumption, height, weight, waist circumference, and smoking status were recorded. BMI, BRI, and ABSI were separately calculated. Serum creatinine, glucose, glycated hemoglobin, and uric acid were evaluated. HGS was measured using a digital dynamometer, and physical activity was assessed by the International Physical Activity Questionnaire. Student t test, χ2 test, Pearson correlation coefficient, and multivariable linear and logistic regression models were performed for data analysis. HGS was not correlated with BMI (r=-0.004, P=0.930), BRI (r=-0.080, P=0.190), and ABSI (r=-0.019, P=0.750). The multivariable linear regression models showed that HGS was not significantly associated with BMI (β= 0.01; 95% CI, -0.11 to 0.12), BRI (β= -0.04; 95% CI, -0.34 to 0.25), and ABSI (β= 43; 95% CI, -38 to 124). The multivariable logistic regression models displayed no significant association between dynapenia with BMI (OR= 1.00; 95% CI, 0.92-1.09), BRI (OR= 1.06; 95% CI, 0.84-1.34), and ABSI (OR= 0.80; 95% CI, 0.55-1.14). There were no associations between BMI, BRI, and ABSI with HGS. Furthermore, in postmenopausal women, dynapenia was also not associated with these anthropometric indices of obesity.

Recently, obesity has exceeded underweight as the more prevalent form of malnutrition among school age children and adolescents globally. This development highlights the importance of understanding the causes and mechanisms through which childhood obesity manifests. Children's weight status - and dietary intake - underlie many influences, including maternal weight status. We aimed to examine how maternal overweight and obesity in a prenatal and a postnatal context influence offspring's dietary intake and their weight status in childhood and adolescence. We searched four databases for studies examining 3- to 17-year-old's dietary intake in relation to maternal weight status. A PRISMA-guided approach was followed to identify all studies eligible to contribute to our questions and 33 studies that met criteria were identified. Data were extracted and analyzed qualitatively, differencing between the temporal context of maternal overweight/obesity and several aspects of the child's dietary intake. Findings were highly heterogenous: Neither of the aspects of dietary intake showed a uniform direction with regards to maternal weight status. There was a tendency to increased adiposity rates among children exposed to postnatal maternal overweight compared to children exposed to prenatal maternal overweight, although the tendency was small. These observations are in line with recent narrative reviews that emphasize the importance of a multitude of factors, rather than the maternal BMI alone, in shaping children's dietary development.

To evaluate the methodological feasibility of a heterogeneous multi-output Gaussian process model for jointly handling a continuous birth outcome and its clinically used binary representation in routinely collected perinatal data, and to compare its predictive performance with that of conventional single-output models. Routinely collected live-birth certificate data from Medellín, Colombia, covering births from 2012 to 2021, were analyzed. After cleaning and class balancing, the analytic dataset included 32,110 records. A heterogeneous multi-output Gaussian process model was trained to jointly model birth weight in grams with a Gaussian likelihood and low birth weight status with a Bernoulli likelihood. Predictive performance was compared with that of conventional single-output regression and classification models. The heterogeneous multi-output Gaussian process model achieved acceptable predictive performance (R² = 0.67 for birth weight and accuracy = 0.845 for low birth weight classification), with results comparable to those of models fitted separately for each task. These findings support the practical feasibility of modeling heterogeneous outputs within a single probabilistic framework. In this application, the heterogeneous multi-output Gaussian process model was a viable methodological alternative for jointly modeling birth weight in grams and its binary low-birth-weight classification. This study should be interpreted primarily as a methodological demonstration of a flexible multi-output framework in perinatal data that may be extended in future studies to jointly model other outcomes of greater direct relevance to public health.

Emerging literature links life dissatisfaction with maladaptive coping mechanisms, including compulsive eating, particularly in environments with limited health-promoting resources. This study explores how life satisfaction interacts with psychological and sociostructural factors to influence obesity risk, with a focus on the role of weight perception across the lifespan. A thorough search was conducted, and data were uploaded in Covidence, a validated website-based screening and data extraction tool. After an extensive review process, 83 studies remained for extraction. A qualitative approach was then used to synthesize the articles, primarily effects of age. Our analysis also considered effects of gender, geographical/racio-ethnic, and cultural differences. Across the lifespan, life satisfaction was more strongly predicted by weight perception rather than BMI or objective weight status. This effect was particularly pronounced in females, who showed greater vulnerability to negative weight perception compared to their male counterparts. The findings emphasize the psychological burden of perceived body image and its role in driving dissatisfaction, irrespective of clinical weight categories. The findings highlight the influence of gender, geography, and cultural factors in the interplay between life satisfaction and obesity. This research supports a biopsychosocial framework of obesity, highlighting effects of weight perception on life satisfaction and health behaviors. Interventions aimed at psychosocial well-being and reframing weight perception, especially among young females, may serve as protective factors against maladaptive eating behaviors and long-term obesity. Future obesity interventions should consider life meaning, personality traits, and perceived body image to better target at-risk populations.

Unidirectional associations of physical activity with recreational screen time habits and intentions: A one-year longitudinal study in early adolescents.

Food insecurity (FI) is associated with poorer physical and mental health outcomes, exacerbation of chronic diseases, and decreased access to healthcare. Children experiencing FI face additional risks, including lower psychosocial functioning and reduced academic achievement. Although national initiatives call for integrating nutrition support services into healthcare, clinical workflows for FI screening and referral remain inconsistently implemented and difficult to sustain. The goal of this study is to refine, adapt, and optimize a comprehensive FI screening and referral program, and identify effective implementation strategies for pediatric healthcare systems. We will use a RollOut Implementation and Optimization (ROIO) trial design to iteratively implement and refine the implementation strategies for our FI screening and referral program (I-FRESH: Implementing Food Referrals for Equity and Sustained Health) across 4 pediatric clinics. I-FRESH includes: (1) FI screening; (2) assessment of family needs and readiness to access services; (3) referral and navigation support to community nutrition programs; and (4) follow-up to assess fit, utilization, and ongoing needs. The Pragmatic, Robust Implementation and Sustainability Model (PRISM) will guide adaptation and evaluation of contextual determinants, while RE-AIM will guide assessment of outcomes (implementation feasibility and acceptability, fidelity, adoption, reach, effectiveness, and maintenance). We will identify several implementation strategies to increase the likelihood that I-FRESH can be successfully implemented and sustained in a pediatric healthcare system. We will enroll 240 participants and assess preliminary effectiveness on family‑level food security and pediatric nutrition‑related health outcomes (e.g. weight status, blood pressure, lipids, HbA1c, liver function tests). The information gathered in this trial will be utilized in the development of a fully powered Type 2 Hybrid Effectiveness-Implementation Trial that will test the effectiveness of the identified implementation strategies and impact of the FI program on clinical outcomes. By integrating PRISM and RE-AIM within an iterative ROIO design, this study will generate a scalable, contextresponsive implementation model for addressing FI in pediatric healthcare settings. Findings will inform sustainable strategies that link families to highquality nutrition support programs and improve nutritionrelated health outcomes for lowincome children. NCT06661538.

Child and adolescent overweight and obesity are rising in China, yet how parental words, namely verbal encouragement, and actions, namely parents' own physical activity, relate to weight status remains unclear. This study estimated the associations of four observed parental role-modelling patterns, defined by parental verbal support and guideline-level parental physical activity, with overweight and obesity in children and adolescents. Cross-sectional data were drawn from the Shanghai site of the Physical Activity and Fitness in China, The Youth Study from 2016 to 2020. The study included children and adolescents in Grades 4 to 12, each linked to one responding parent. Parental verbal support and parental physical activity were assessed by questionnaire. Two binary indicators, verbal support and guideline-level parental physical activity, were cross-classified to define four role-modelling patterns: no verbal support and no guideline-level parental physical activity (NS), verbal support only (VO), guideline-level parental physical activity only (AO), and both verbal support and guideline-level parental physical activity (BS). Child height and weight were measured objectively, BMI was calculated, and overweight or obesity was defined using WHO age- and sex-specific references. We used cluster-adjusted logistic regression to estimate adjusted odds ratios (aORs) for overweight or obesity, with adjustment for sociodemographic covariates. Subgroup-specific estimates were examined descriptively, and formal interaction tests were conducted in the full analytic sample. Data from 18 479 parent-child dyads (aged 9-18years) were analysed; VO was most common (42.1%), followed by BS (26.8%), NS (22.4%), and AO (8.7%). Overall, 23.2% had overweight or obesity. Compared with NS, AO was associated with lower odds of overweight or obesity (aOR 0.82, 95% CI 0.69-0.96). BS was associated with even lower odds (aOR 0.57, 95% CI 0.50-0.65), suggesting a greater magnitude of association, whereas VO showed no evidence of association (aOR 0.99, 95% CI 0.98-1.01). BS was associated with lower odds across all examined subgroups, whereas the association for AO was more evident in Grades 7-9, non-only children, and higher-income households. Guideline-level parental physical activity was more consistently associated with healthier weight status among children and adolescents than verbal support alone. The combination of verbal support and guideline-level parental physical activity was associated with the lowest odds of overweight or obesity. Family-based obesity prevention should support parents in developing active routines and aligning verbal encouragement with their own physical activity.

Weight stigma and misconceptions about obesity among healthcare professionals (HCPs) may negatively affect healthcare quality and access for people living with obesity (PLWO). However, no previous research has examined these attitudes and beliefs in Spanish HCPs. This cross-sectional online study examined weight stigma and obesity-related beliefs among 922 HCPs recruited via Spanish professional and academic obesity-related organizations ((74.1% female, mean BMI = 23.73 kg/m2 (SD 3.89), mean age = 43.73 years (SD 12.45), range 23–75, 88.7% provide care for PLWO)). Anti-fat attitudes were measured using the Dislike subscale of the Anti-Fat Attitudes questionnaire (AFA) and the Fat Phobia Scale (F-Scale). ANOVAs adjusted for sociodemographic variables, weight status, and weight bias internalization were conducted. Overall, Spanish HCPs surveyed reported negative attitudes toward PLWO. Lower weight status was consistently associated with higher stigma scores. Younger age (F-Scale) and working in the private sector (Dislike) were associated with higher scores. Differences across specialties were observed, with obesity physicians reporting the lower stigma levels. A substantial proportion of HCPs endorsed beliefs emphasizing personal responsibility: 38% attributed overeating to individual causes, 66% believed obesity could be entirely prevented by a healthy lifestyle, and 59% believed it could be cured through lifestyle changes. Many also attributed weight loss difficulties, poor compliance, and weight regain to lack of motivation and lifestyle choices, and over half considered lifestyle or psychological interventions the most effective treatment for severe obesity. Endorsement of these beliefs was consistently associated with higher stigma scores. These findings provide national evidence that weight stigma among Spanish HCPs is present and linked to beliefs framing obesity as primarily under individual control. These attitudes and knowledge gaps may contribute to inappropriate care and unfair treatment of PLWO. Addressing responsibility-focused beliefs may be a key step towards reducing stigma and improving the quality of obesity care in Spain.

Eating disorder severity and treatment outcome across race/ethnicity, sexual orientation, and socioeconomic status: Intersectional inequities in a clinical sample.

Emotional eating is associated with negative outcomes in children, including elevated weight status and disordered eating. The current study assessed the preliminary psychometric properties of a 10-item parent-report version of the Emotional Eating Scale Adapted for Children (EES-C) Short-Form. Participants were 324 mothers of children ages 5-12years. The parent-report version of the EES-C Short-Form and the Child Feeding Questionnaire were administered to mothers in the United States online. Cronbach's alpha for the parent-report version of the EES-C-Short-Form was in the excellent range (α = .94). Mothers reported significantly higher levels of emotional eating in overweight/obese children than healthy weight children eating (effect size = 0.45, p < .001). Maternal reports of their child's emotional eating on the EES-C-Short-Form were associated with maternal concern about their child's weight (r = .285; 95% confidence interval = .18-.39), restricted eating (r = .238; 95% confidence interval = .13-.35), and monitoring of their child's food intake (r = .136; 95% confidence interval = .02-.25) on the Child Feeding Questionnaire, supporting convergent validity. A unidimensional model produced a good fit (χ2 (35) = 70.31, p = 0.00, CFI = .999, SRMR = .036). Taken as a whole, this study provides preliminary support for the reliability and validity of the parent version of the EES-C Short-Form.

To evaluate the effects of a 10-week school-based flag football programme on fitness outcomes in Chinese children aged 9 to 11years. A two-arm, parallel-group randomized controlled trial was conducted in a public primary school in Shanghai, China. Children (n = 147) were randomized to either flag football (n = 74; mean age, 9.7 ± 0.5 years; 30 girls) or usual physical education (PE; n = 73; mean age, 9.7 ± 0.5 years; 32 girls). The intervention comprised 60-min sessions, delivered twice weekly for 10weeks. Outcomes were assessed at baseline and post-intervention: the 20m shuttle run test (laps), estimated maximal oxygen uptake (VO₂max), the 1-min jump rope test (turns), and the 50m dash (seconds). Primary analyses followed the intention-to-treat principle using multiple imputation and repeated-measures models; subgroup analyses were conducted by sex and baseline weight status. Session intensity was monitored through heart rate (HR) in a subsample. Post-intervention data were available for 128 children (87.1%). Compared with usual physical education, the flag football group showed greater improvements in 1-min jump rope performance (between-group difference in change = 7.4 turns; p = 0.03) and 50 m dash time (between-group difference in change = -0.3 s; p = 0.013). No between-group differences in change were observed for 20 m shuttle run performance (0.7 laps; p = 0.32) or estimated VO2max (0.19 mL·kg-1·min-1; p = 0.37). Subgroup analyses revealed the most significant effects in boys with normal weight for estimated VO2max and 20 m shuttle run, boys across BMI status groups for sprint performance, and girls across BMI status groups for jump rope. A PE-embedded flag football programme effectively improved sprint speed and 1-min jump rope performance. The observed sex- and weight-specific responses suggest the need for differentiated task progression in school-based interventions to maximize fitness benefits. Trial registration: ISRCTN registry (Current Controlled Trials), ISRCTN62093106; registered 04 February 2026 (retrospectively registered).

Socioeconomic status (SES) is associated with inequities in children's body weight. Yet little is known about whether features of the urban food environment modify this association. We assessed whether and to what extent the availability of unhealthy food retailers modifies the association between area-level SES and weight status among children, overall and by sex. We conducted an ecological study using individual data from a city-wide representative survey of 3505 children, aged 3 to 12 years living in Madrid, Spain. We measured area-level SES at the census-section level using a composite measure and categorized it into tertiles, with T3 representing the highest area-level SES. Our outcome variables were overweight and obesity, measured using anthropometric data on height and weight. As a potential effect modifier, we examined the availability of unhealthy food retailers around children's households. Using Geographic Information Systems, we calculated 400-m street-network buffers and categorized unhealthy retailers' availability into tertiles. We used Poisson regression models with robust standard errors to estimate prevalence ratios (PR) and 95% confidence intervals (CI), adjusting for age, sex, and population density. Overall, the prevalence estimates for overweight and obesity were 26.2% and 16.6%, respectively. Compared with children living in high-SES areas (T3), those living in the lowest-SES areas (T1) showed a higher prevalence of overweight (PR = 1.31, 95% CI: 1.13, 1.51) and obesity (PR = 2.30, 95% CI: 1.75, 3.03). Among children with the lowest exposure to unhealthy food retailers, overweight prevalence was higher for children in low-SES areas than in high-SES areas (PR = 1.44; 95% CI: 1.06, 1.96). For obesity, the prevalence was also higher among children living in low- (T1; PR = 3.96, 95% CI: 2.36, 6.65) and medium-SES areas (T2; PR = 2.40; 95% CI: 1.42, 4.07) relative to those living in high-SES areas (T3). We found a statistically significant interaction between area-level SES and unhealthy food retailer availability for obesity on both additive and multiplicative scales. Our findings suggest that the urban food environment modifies the association between area-level SES and childhood obesity, whereas the evidence was less consistent for overweight. The persistence of higher obesity prevalence in lower-SES areas, even where exposure to unhealthy food retailers was lower, indicates that food environment interventions may not be sufficient to reduce socioeconomic inequities unless complemented by other structural approaches that address social disadvantage.

Determinants of childhood and adolescent obesity: An explainable AI approach using the ICAD database.

Current clinical practice guidelines recommend that pediatricians screen all youth for overweight/obesity and provide or refer to treatment those with elevated weight status. Despite pediatricians' intentions to provide high-quality care, weight stigma and bias impede health care delivery. A shift in training is needed to optimize the experiences of adolescents with high weight status (body mass index ≥85th percentile) during primary care visits. The present study sought adolescent, caregiver, and pediatrician perspectives on current practice, gaps in care, and needs for training to address health behaviors in youth at high weight status. Individual qualitative interviews were conducted with adolescents with high weight status (ages 13-17), their caregivers, and pediatricians. Recruitment occurred primarily through a hospital-based primary care practice in the Northeastern United States. Interviews were audio recorded, transcribed, and analyzed using an applied thematic analysis approach. A total of 13 adolescents, 13 caregivers, and 11 pediatricians participated in the study. Themes from adolescents and caregivers included preferences for weight-specific communication, the importance of patient centered care, and specific guidance for pediatricians delivering care. Themes from pediatricians included philosophy of addressing high weight status, gaps in training, and preferred components of a future training. Multiple perspectives, including patients and pediatricians, emphasize the need to develop further training for pediatricians to improve care for adolescents at high weight status to meet current clinical practice guidelines. Findings provide specific guidance for development of pediatrician-focused training to navigating health behavior and weight-related conversations using a patient-centered approach.